Falls are an important health problem for elderly persons because of resulting suffering and functional decline. In our earlier study, 30% of the community elderly subjects fell; 25% of the fallers suffered a serious injury. Serious injury was associated with functional decline-as measured by decreased mobility- independent of number of falls or physical ability. The aims of the proposed project are: 1) to identify the incidence of, and risk factors for, serious injuries during a fall; and 2) to verify the independent contribution of serious injury to decline in mobility among elderly fallers. The project is a five-year study of the estimated 1,029 eligible members of the Yale Health and Aging Cohort who agree to participate. Hypothesized risk factors for serious injury include factors associated with force of impact of the fall and factors associated with protective responses of the faller. The outcome variables will be serious injury and change in mobility during the study period. Risk and outcome variables will be ascertained during baseline and yearly assessments as well as during followup contacts. Followup contacts include: 1) weekly postcards; 2) immediate telephone calls to ascertain circumstances of fall; and 3) quarterly telephone interviews for all subjects. Each subject will be followed for three years. If, as we postulate, much of the suffering, health care expense, and loss of function associated with falling results from injury, then the factors associated with injury should be identified and targeted in preventive programs. The modifiable risk factors identified in this study will allow the development of targeted, effective preventive programs. This proposal is a revised version of Application AG07449.